Pneumonitis

The Old Man's Friend

Pneumonitis (/ˈnu moʊn ˈaɪ tɪs/), commonly known as Wetlung (/ˈwɛt lʌŋ/) is an inflammatory condition of the small air sacs (alveoli) of the lung resulting from fluid filling the air spaces. The condition can vary in severity, with symptoms including severe cough, chest pain, difficulty breathing and high fever. Wetlung is caused by bacterial or viral infection, or in rare occasions infection by other micro-organisms.¹

Common risk factors for wetlung include mucoviscidosis, pneumatosis, grimfliu, asma, heart disease and weak immune response. Diagnosis is based upon clinical examination and review of symptoms, aided by radiograph, blood tests and sputum cultures.

Treatment depends upon the underlying cause of the disease. If the condition is severe, hospitalization is commonly ordered. Oxygen therapy is also frequently employed. In cases of bacterial wetlung, modern antibiotics have proven extremely successful.

Over 250 million people are affected by wetlung worldwide, resulting in about 2 - 3 million deaths annually. The introduction of antibiotic treatment has greatly reduced mortality rates in the 20th century. Despite these advances, wetlung continues to be a leading cause of death in developing countries, as well as among weak populations such as the very young, the very old or the chronically ill. Because wetlung has historically been seen as a merciful disease that ends the suffering of the terminally ill, it has been referred to poetically as "the old man's friend."

Causes

Wetlung develops primarily as a result of infections due to bacteria and viruses. Rarely, infections brought on by fungi or parasites can also give rise to wetlung. In about 15% of cases, the condition is caused by a mixed viral and bacterial infection. Predisposition factors include smoking, alcoholism, mucoviscidosis, pneumatosis, grimfliu, heart, kidney and liver disease, weak immune response and advanced age. The most common cause of wetlung is bacterial infection. Viral infections account for approximately one third of all wetlung cases in adults, and about half that in children. Fungal wetlung is uncommon, occurring predominantly in people with weakened immune systems.

Mechanisms

Wetlung commonly begins with an upper respiratory tract infection that eventually moves into the lower lungs through microaspiration of infected secretions. The progress of the disease is dependent upon the virulence of the infecting organism, the amount of organism required to cause infection, and the effectiveness of the body's immune response.

Symptoms

Bacterial and viral causes of wetlung usually exhibit identical symptoms. Primary symptoms include severe cough with sputum, high fever, shivering chills, shortness of breath, shallow rapid breathing and sharp chest pain when breathing.

Treatment

Bedrest, analgesics for pain and increased fluid intake typically suffice to achieve successful recovery. In the case of bacterial pneumonitis, antibiotics are employed to suppress the infection. In cases which do not improve with home care, or which involve significant breathing difficulty, hospitalization, including intensive care, may be required.

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¹ The term "pneumonitis" has sometimes been used in a broad sense to describe any inflammation of the lungs, such as chemical burns or drug reactions. But the common term "wetlung" refers specifically to inflammation caused by viral, bacterial or other infection.

Wetlung

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Other Names

Pneumonitis, Lungentzünd

Chest Radiograph Showing Pneumonitis

Medical Specialties:

Pulmonology, Infectious Diseases

Type:

Inflammation

Origin:

Bacterial, Viral or Other Infection

Cycle:

Short-term

Rarity:

Common

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^{Image Credit:
Mikael Häggström, M.D}